Announcement

**HenryN** · December 31, 2008, 12:00 PM

Re: Seasonal Flu 2008 - 2009

Neuraminidase inhibitor susceptibility testing was not carried out during this Christmas - New Year holiday period.

Canada:

Since 1 September 2008, 20 influenza viruses have been
characterised: three influenza A/Brisbane/59/
2007(H1N1)-like, two A/Brisbane/10/2007 (H3N2)-like,
three influenza B/Florida/4/2006-like and 12 B/Malaysia/
2506/2004-like, the latter was a component of the 2007/
08 vaccine. Six influenza A (H1N1) isolates have been

tested and found to be resistant to oseltamivir.

**HenryN** · December 31, 2008, 01:47 PM

Re: Seasonal Flu 2008 - 2009

Colorado influenza summary - Week ending 12/27/08

INFLUENZA ACTIVITY

Gradually increasing level of influenza activity, especially in El Paso County, based on the number of hospitalizations and increasing sentinel laboratory positivity.
Local activity was reported to CDC for the first time this season.

INFLUENZA-LIKE ILLNESS SURVEILLANCE FROM KAISER PERMANENTE
(DENVER METRO REGION)

0.9% - week ending 12/13/08
0.8% - week ending 12/20/08
0.9% - week ending 12/27/08
NOTE: The inter-season range from June through September was 0.4% - 0.8%.

REPORTED INFLUENZA-ASSOCIATED HOSPITALIZATIONS

1 - week ending 12/13/08
1 - week ending 12/20/08

3 - week ending 12/27/08

7 (Cumulative 10/04/08 ? 12/27/08)

TYPE AND STRAIN INFORMATION
(CUMULATIVE 12/02/08 ? 12/27/08)

Type A Influenza = 20

? Subtype H3 = 11
? Subtype H1 = 7

</DIR></DIR>

Type B Influenza = 1
NOTE: Type and strain information is based on direct fluorescent antibody (DFA), RT-PCR and viral culture results. Results included in strain surveillance do not necessarily represent hospitalizations and should not be regarded as cases.

SENTINEL LABORATORY SURVEILLANCE

Based on 15 reporting labs, 386 specimens were tested for influenza of which 21 (5.4%) were positive for A.

REPORTS OF OUTBREAKS OF INFLUENZA

There were no influenza outbreaks reported in the past week.

For additional information, please go to our web site at:

Home | Department of Public Health & Environment

http://www.cdphe.state.co.us/dc/Influenza/index.html

Home | Department of Public Health & Environment

http://www.cdphe.state.co.us/dc/Influenza/flu_sum.pdf

**HenryN** · December 31, 2008, 01:53 PM

Re: Seasonal Flu 2008 - 2009

Influenza Surveillance Program for 2008 - 2009

<HR noShade>Week 52 (Dec 21-27, ?08) Report
This Week"s Activity Level is:

<TABLE cellPadding=2 width="95%" align=center border=1><TBODY><TR><TD vAlign=top bgColor=#ffff00 colSpan=2>

?Local?
Reports from Sentinel Providers indicate an elevated level of influenza-like illness in one surveillance region the State AND there are now lab-confirmed cases of influenza.)

</TD></TR><TR><TD vAlign=top>Reports of visits for influenza-like illness (ILI) to sentinel providers. This week, a total of 59 visits for ILI were reported by 7 providers. The median percent of ILI visits in Maryland was 1.5%. This is below the state baseline of 3.6%.
Sentinel providers are health care providers who report to us the proportion of patient visits for influenza like illness. Because of the great variability in reported ILI proportions among providers each week, the median ILI is used instead of the average. Half of the ILI reports were below the median and half were above.
If you are interested in becoming a sentinel provider, please feel free to contact us at flu@dhmh.state.md or by phone at 410-767-6700.
</TD><TD vAlign=top>

Click on graph to enlarge

</TD></TR><TR><TD vAlign=top>Reports of rapid influenza tests from clinical laboratories. During week 52, a total of 255 rapid influenza tests were reported by 9 reporting clinical laboratories. Of these, 18 tests (7.1%) were positive.
Because the sensitivity and specificity of rapid flu tests vary with the prevalence of influenza in the population*, rapid flu tests performed before the first DHMH lab-confirmed case are not counted as confirmed cases for the purpose of surveillance. Now that the DHMH laboratory has confirmed a case by reference methods, all rapid influenza tests will be counted as confirmed cases.
</TD><TD vAlign=top>

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</TD></TR><TR><TD vAlign=top>Reports of reference testing on submitted specimens from the Public Health Laboratory. During week 52, a total of 19 specimens were submitted for testing at the DHMH laboratory. One (5.3%) of these were positive for influenza. This season, a total of 130 specimens have been submitted for testing at the DHMH laboratory. Of these, 7 (5.4%) have been positive by PCR. Four specimens (3.1%) were positive for influenza Type A, and three specimens (2.3%) were positive for influenza Type B.
For the purpose of influenza surveillance, cases are counted as ?confirmed? when they are based on more reliable reference test methods (PCR or culture) performed by the DHMH lab, or are based on other techniques such as rapid test for the detection of influenza antigen AFTER the DHMH lab has confirmed its first case of the season.
This is done because the sensitivity and specificity of rapid flu tests vary with the prevalence of influenza in the population*, and are less reliable when prevalence is low. This season, all positive clinical laboratory results from week 46 onward (45) are counted as confirmed cases, and of course, all the positive DHMH lab results (3).
The seven positive specimens identified by the DHMH lab have been typed as influenza A (4, 57%) and influenza B (3, 43%). To date, the CDC laboratory has identified two as type A (H1N1) Brisbane-like and another as type B Florida-like. Both strains are components of this season?s influenza vaccine. The type A (H1N1) isolate was found to be resistant to Oseltamivir (Tamiflu ?) but sensitive to Adamantanes and Zanamivir. Interim guidelines on the use of antivirals for influenza can be found at http://tinyurl.com/cdcinterim.</TD><TD vAlign=top>

Click on graph to enlarge

</TD></TR><TR><TD vAlign=top>

Reports of outbreaks of influenza in schools and other institutions. One outbreak of pneumonia was reported to the Division of Outbreak Investigations this week.
Although influenza is not a reportable condition in Maryland, outbreaks of influenza in institutional settings are reportable. Please contact your local health department to report an outbreak.
For more information about outbreak investigations in Maryland, please visit:
http://edcp.org/html/otbkhmpg.html.

</TD><TD vAlign=top>

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</TD></TR><TR><TD vAlign=top>Reports of hospitalizations due to influenza. No reports were filed this week due to the Holidays.
To date, there have been 84 (47, 56% adult, and 37, 44% pediatric) hospitalizations for influenza reported to DHMH. Last season, 715 (516, 72% adult, and 199, 28% pediatric) hospitalizations were reported.
The Emerging Infections Program collects information on a weekly basis from several hospitals in the Baltimore Metro Region on the number of hospitalizations associated with influenza.
</TD><TD vAlign=top>

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</TD></TR><TR><TD vAlign=top>Reports from Maryland residents. A total of 444 participants signed up at http://tinyurl.com/flu-enroll by the end of week 52. Of the 444 residents who received the weekly survey, 224 (50%) responded to it. Among the respondents, 3 (1.3%) reported flu-like symptoms. One of the respondents reported getting his or her flu vaccine this week.
Because there is no baseline to compare these results, and the sample size is small (compared to the population), caution must be taken when interpreting the results.
We continue to recruit participants. Please enroll at the link above or pass on the link to anyone interested.
If you would like to participate in the resident flu tracking survey, please visit THIS SITE [https://www.surveymonkey.com/s.aspx?sm=eIGPl_2bIZTs3qV90lureTog_3d_3d]or email us at flu@dhmh.state.md.us.
</TD><TD vAlign=top>

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</TD></TR><TR><TD vAlign=top> </TD><TD vAlign=top>

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</TD></TR><TR><TD vAlign=top colSpan=2>

Click Here to Download This Week's Report in PDF Format

</TD></TR></TBODY></TABLE>

**HenryN** · December 31, 2008, 02:03 PM

Re: Seasonal Flu 2008 - 2009

Iowa report

http://www.idph.state.ia.us/adper/common/pdf/flu/flu_report_51.pdf

**HenryN** · December 31, 2008, 02:15 PM

Re: Seasonal Flu 2008 - 2009

Lab Surveillance:

Laboratories report positive influenza tests to ADHS. Of the lab-confirmed influenza reported this season, 18 are influenza A, 7 are influenza B and 2 are unknown.

Page or Document Not Found

http://azdhs.gov/phs/oids/epi/flu/pdf/az_fluweb_52_0809.pdf

**HenryN** · December 31, 2008, 03:44 PM

Re: Seasonal Flu 2008 - 2009

North Carolina

404 - File or directory not found.

http://www.epi.state.nc.us/epi/gcdc/flu2009.html

**HenryN** · December 31, 2008, 03:55 PM

Re: Seasonal Flu 2008 - 2009

Laboratory Data
Two WHO/NREVSS collaborating laboratories in Washington reported data for week 50. Three of the 183 (1.6%) specimens tested were positive for influenza. One was influenza A(H3N2) and two were influenza A(unknown subtype). To date, eight specimens tested by collaborating laboratories in Washington have been positive for influenza (two A-H1, one A-H3, four A-unknown subtype, and one B) since the start of the influenza surveillance season.
In the Pacific Region, six WHO/NREVSS collaborating laboratories reported testing 317 specimens during week 50. Twelve (3.8%) were positive (8 A-H1, 1 A-H3, and 3 A-unknown subtype). Last week 2.6% of specimens tested were positive for influenza. Since the beginning of influenza surveillance season, 3.5% of all specimens tested have been positive for influenza. The table and chart below show cumulative influenza isolates from the Pacific Region reported by WHO/NREVSS collaborating laboratories.

Pacific Region - Influenza Isolates

<TABLE id=table6 width="100%" border=1><TBODY><TR><TD align=middle>A(H1)</TD><TD align=middle>A(H3)</TD><TD align=middle>A(Unk)</TD><TD align=middle>B </TD><TD align=middle width=78>Total Influenza</TD><TD align=middle width=89>Total # Tested</TD><TD align=middle width=69>% Positive</TD></TR><TR><TD align=middle>122</TD><TD align=middle>6</TD><TD align=middle>62</TD><TD align=middle>11</TD><TD align=middle width=78>201</TD><TD align=middle width=89>5709</TD><TD align=middle width=69>3.5</TD></TR></TBODY></TABLE>

Page not found | Washington State Department of Health

http://www.doh.wa.gov/EHSPHL/Epidemiology/CD/fluupdate.htm

**vinny** · December 31, 2008, 04:10 PM

Re: Seasonal Flu 2008 - 2009

what are the chances of brisbane flu,i think that was what is was called,the one they have had in australia.that hit people quite hard,is it still around and what are the chances of it reaching the uk if it is.......?.

one more question if anyone can answer it please there has been a chesty cough virus going around the uk,with no other symptoms just those,any idea what it is.people get it and i thought if you had,had it your body would have a defence against you getting it again but it doesnt i have family and friends who have had this more than once.thanks for any advice.

**HenryN** · December 31, 2008, 04:34 PM

Re: Seasonal Flu 2008 - 2009

Originally posted by vinny View Post

what are the chances of brisbane flu,i think that was what is was called,the one they have had in australia.that hit people quite hard,is it still around and what are the chances of it reaching the uk if it is.......?.

one more question if anyone can answer it please there has been a chesty cough virus going around the uk,with no other symptoms just those,any idea what it is.people get it and i thought if you had,had it your body would have a defence against you getting it again but it doesnt i have family and friends who have had this more than once.thanks for any advice.

Both influenza sub-types are from Brisbane. H1N1 is Brisbane/59 while H3N2 is Brisbane/10. UK has both but 90% of infleunza A is H3N2.

However, UK also has the norovirus, which isn't flu and produces GI symtoms. There are also other respiratory viruses like RSV, which also are not flu.

**HenryN** · December 31, 2008, 04:58 PM

Re: Seasonal Flu 2008 - 2009

This Page Does Not Exist

http://dhs.wisconsin.gov/communicable/influenza/pdf_files/Surveillance08_50.pdf

Please use the Search or A-Z index to find what you are looking for.

<TABLE dir=ltr cellSpacing=0 cellPadding=7 width=835 border=1><TBODY><TR><TD vAlign=top colSpan=14 height=6>6. Antiviral resistance: ADAMANTANE RESISTANCE
</TD></TR><TR><TD vAlign=top width="26%" colSpan=2 height=19 rowSpan=3>Season/Lab
</TD><TD vAlign=top width="74%" colSpan=12 height=19>Influenza Subtype
</TD></TR><TR><TD vAlign=top width="15%" colSpan=4 height=6>A/H1
</TD><TD vAlign=top width="25%" colSpan=5 height=6>A/H3
</TD><TD vAlign=top width="34%" colSpan=3 height=6>B
</TD></TR><TR><TD vAlign=top width="2%" height=6>Tested
</TD><TD vAlign=top width="13%" colSpan=2 height=6>Resistant
</TD><TD vAlign=top width="13%" colSpan=3 height=6>Tested
</TD><TD vAlign=top width="13%" colSpan=2 height=6>Resistant
</TD><TD vAlign=top width="13%" colSpan=2 height=6>Tested
</TD><TD vAlign=top width="21%" colSpan=2 height=6>Resistant
</TD></TR><TR><TD vAlign=top width="14%" height=6>07-08
</TD><TD vAlign=top width="17%" colSpan=3 height=6>Combined
</TD><TD vAlign=top width="17%" colSpan=3 height=6>969
</TD><TD vAlign=top width="17%" colSpan=2 height=6>9.8%
</TD><TD vAlign=top width="17%" colSpan=4 height=6>571
</TD><TD vAlign=top width="17%" height=6>99.8%
</TD></TR><TR><TD vAlign=top width="14%" height=6>08-09
</TD><TD vAlign=top width="17%" colSpan=3 height=6>WI
</TD><TD vAlign=top width="17%" colSpan=3 height=6>-
</TD><TD vAlign=top width="17%" colSpan=2 height=6>-
</TD><TD vAlign=top width="17%" colSpan=4 height=6>-
</TD><TD vAlign=top width="17%" height=6>-
</TD></TR><TR><TD vAlign=top width="14%" height=6>08-09
</TD><TD vAlign=top width="17%" colSpan=3 height=6>CDC
</TD><TD vAlign=top width="17%" colSpan=3 height=6>50
</TD><TD vAlign=top width="17%" colSpan=2 height=6>0%
</TD><TD vAlign=top width="17%" colSpan=4 height=6>8
</TD><TD vAlign=top width="17%" height=6>100%

</TD></TR></TBODY></TABLE>

OSELTAMIVIR RESISTANCE
Influenza Subtype
A/H1
A/H3
B
Season/Lab
Tested
Resistant
Tested
Resistant
Tested
Resistant
07-08
Combined
1,062
11.3%
454
0%
350
0%
08-09
WI
-
-
-
-
-
-
08-09
CDC
50
98%
8
0%
20
0%